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World Trade Center Disaster Response


New York City Department of Health
Day 8: 9/18/01 (Tuesday)
8am-8pm Summary
COMMAND CENTER AND OEM OPERATIONS
OEM is all at Pier 92, downtown site now just for fit test teams
On call sheet should be filled out before 5 pm meeting each day
Meetings today at 12 noon and 5 pm
Meeting at 125 Worth at 2:30 pm

I. Environmental Workgroup
Occupational Health and Safety Plan for worker safety at site
Jim Miller handed out Comprehensive Health, Safety, Environmental Service Plan
Not using Bechtel plan

Personal Protective Equipment in plan - PI00 respirators, gloves, goggles


Construction workers are the largest group of people who need to be addresses

Respirators - most people on site are not wearing them, more accountability needed
Inventory of respirators are a problem
Lack of respirators and cartridges is largest problem
Jim Miller asked OEM to order 20,000 masks and 40,000 cartridges

Fit testing - DOH is trying to take over setting policy, but should be consistent with
OSHA regulations
3 testing sites, 15-20 people at each site but no respirators, no one checking on
inventory, need someone here to be responsive to inventory needs
Donations of respirators will only be accepted if they come from manufacturer
Locations of fit testing centers is moving
Around 50 persons are being used to staff centers

OSHA has on site safety monitors now, like spotters for cranes, etc.

FEMA employees are following their own policy, don't agree with ours

Showers offered
We thought Coast Guard was organizing this - ask Kelly
Decontamination stations - not clear where they are being set up

Air quality
2 pm Environmental sampling meeting
Hg monitoring was fine
Bulk dust samples, 1-3% asbestos
Perimeter all less than 1%
As demolition proceeds, more air quality issues
ConEd had one high PCM reading at .23, confirmed by TEM reading
No sampling plan yet by EPA for all environmental media
Except are doing personal air monitoring
EPA had released press release on 9/14 but we didn't get it until today
Lots of data being generated, Env Workgroup has database
No indication that we need to be doing anything for workers more than what we
are
Air quality for community - need a plan to get re-occupancy information to
people in community, such as a tenant meetings
So far all readings less than 0.01 fibers/cc in
Need to work with OEM in how best to talk to community
Likely that many people are re-occupying buildings without much guidance

Water
Water samples taken from ?where? are negative for asbestos

Food and Restaurant Inspection


Sanitarians access? Difficult at times
World Financial Center - being contacted
Fulton Fish Market is temporarily in Hunts Pt outdoors, downtown is cleaned out
EDC wants to open East St.
Monitoring distribution sites, 2 stations for feeding are being established
State Health Dept and Nassau Co sanitarians (12 persons) will inspect feeding sites
and perimeter
Fire Dept is setting up BBQs at Liberty and ?

Pest control

Re-occupation of buildings
Nothing

Sanitation
Plan to remove garbage below Canal St.

II. Med/Clinical Workgroup


Working on fit testing schedule
6500 bottles of antiseptic towlettes, 6500 bottles of cleanser arriving today
not sure if they got to the site, but did get to DCAS
(DC AS processes order, so if we need more we need to ask for more)
Signs made for site (wearing respirators, not to through away)
Revised health and safety fact sheet was presented

III. Epi/Surveillance Workgroup


Daily summary was not made available last night
1st official summary will be prepared tonight
A. Hospital needs assessment (A Karpati)
GNYHA is taking over that survey, 44 hospitals
Daily number/report to be sent to us daily
B. ER Acute injury/trauma surveillance (S Wilt)
Finishing outstanding charts in 4 hospitals
Plus at burn hospitals
No more sampling needed
C. Syndromic Surveillance (D Weiss)
Going well, good cooperation, prelim data now
No baseline but no unusual clustering
Daily reports will be given back to each hospital
Rapid assessment needed
D. Disaster site worker surveillance for injuries and illness (A Goodman)
Injury and illness, exposure
Early data prelim will be ready soon
Line listed data to be provided on site to organizations
E. Mental health surveillance
Will get some prelim numbers on this from GNYHA survey
Liaison with Columbia Clinical psych personnel

Mental health of DOH staff?

MMWR coming out tomorrow, we were faxed a copy today, reviewing

Regular, ongoing surveillance activities


Dead bird today

IV. Sheltering Workgroup


9 shelters in operation, 1 in Brooklyn
3 sites might be closed tomorrow by ARC, OEM
2 out of 3 of these are the most busy, are located in schools
Homeless persons are being collected to deliver to homeless shelters
ARC providing admin, but not nurses?
Inventory - no problem
Coverage for all sites

VI. Laboratory Workgroup


Received a few calls today about potable water

VII. Operations/Facilities
See attachment that was emailed out today

VIII. MIS.
New W Nile temp hotline, bypass
888-799-8789
Finance at 2 Lafayette up and running

OTHER ISSUES
VIII. Public Relations
More calls today, mainly from outside press, clarification of decomposing bodies
NYT, CBS, CNN, AP about human remains
Trade periodicals, government call about BT
We are calling press to pay attention to our issues
Tomorrow an on site interview about worker safety issues

IX. Personnel/Staffing
Need policy for return to program/regular jobs

Prepared by THH
Status of DOH Building Reoccupancy and Relocation

REOCCUPANCY READY AS OF 9/18/2001


(structurally sound, power on, cleaned, some phones, limited computer)
125 Worth St.
2 Lafayette St.
346 Broadway
66 John St.

NOT READY FOR REOCCUPANCY


253 Broadway RELOCATED TO:
Gay and Lesbian Health 2 Lafayette, 21st Floor
Finance 2 Lafayette, 14th Floor
Complaints/Call Center Labs, 455 First Ave. at 26th St.
Minority Health 2 Lafayette, 21st Floor
Field Operations/Inspections Health Academy at Riverside HC
160 W. 100th at Columbus Ave.
Lead TBA
DI Training TB TBA

225 Broadway RELOCATED TO:


Health Care Access 520 Madison Ave./53rd St., 30th Fl.
TB TBA
HIV Prevention and Ryan White TBA
MPET TBA
Training Institute TBA

40 Worth St. RELOCATED TO:


Veterinary Health TBA
MIS TBA
MHRA Assignees TBA
Call Center/Central Complaints Labs, 455 First Ave. at 26th St.
HealthStat Tremont HC (1826 Arthur Ave., Bronx)
East Harlem HC (158 £.115* St.)
Community HealthWorks Manhattan staff should report to:
East Harlem HC
Brooklyn staff should report to:
Bed-Sty Multiservice Center
Queens staff should report to:
Jamaica Annex
Bronx and SI staff:
should call East Harlem
Shelter Client Usage

Shelter 9/17 9/17 9/17 9/17 9/18 9/18 9/18 9/19 9/19 9/19 9/20 9/20 9/20 9/21
~1A 8A 3P IIP 8A 3P IIP 8A 3P IIP 8A 3P IIP 8A
# # # # ft # # # # # # clients # clients # # clients
clients clients clients clients clients clients clients clients
clients clients clients
Seward Park 5 2 0 4 0
HS
Washington 28 30 40 20 26
Irving HS
Fashion 44 39 55 52 45
Industry HS
Chelsea HS 6 14 3 8 8

Norma Thomas 19 22 22 21 24
HS
City School HS 4 6 2 2 7

JHS22 2 3 0 4 4

IS 131 12 14 17 11 7

Comprehensive 7 6 5 8 8
Day&Night HS
Bayard Rustin Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed
HS

Curtis HS, SI Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed

Westinghouse 49 8 0 1
HS, BK worker workers
Department of Health
World Trade Center Disaster
Emergency Operations Center
Current Issues/Agenda
9/18/01 - 1200 hours

TOPIC OUTSTANDING CONCERNS RESPONSIBLE


PARTY
Radiation and 1) Status of DOE monitoring Allan Goldberg
Monitoring Gene Mishkin
Pest Control 1) Pest control assessment below Canal St James Gibson
2) Garbage pickup below Canal St. - cooperation is going
ok?
Food 1) Restaurants in World Financial Center Elliott Marcus
2) Monitoring of distribution sites - site access problems?
3) Fulton St. Market, Hunts Point Market - any problems?
4) State Health Dept and Nassau Co sanitarians
Water 1) Sampling of water tanks for PCBs and asbestos Jim Luke
2) Agreement with state on water tank protocol
Air 1) Update of air monitoring on buildings Jessica Leighton
2) Update on scientific panel to review and eval data Kelly McKinney
Medical and 1) Fit testing - is it being coordinated? Sue Blank
Clinical 2) Who is coordinating fit testing? Or 5 different sites? Katherine Kaye
3) Respirator inventory - being moved to Armory?
4) Hand washing facilities are available?
Worker Safety 1) Health and Safety Plan (DEC/Bechtel) - Is this being Jessica Leighton
used? Kelly McKinney
2) PPEPlan
Shelters 1) Security problems Carmen Ramos
2) Homeless persons/Security
3) ARC nurses to take over staffing?
Surveillance 1) Retrospective ER injury - all finished? Marci Layton
2) Hospital needs assessment/casualties - summary? Polly Thomas
3) Syndromic surveillance - cluster analysis done?
4) Site/worker safety surveillance - prelim data? New form?
5) Medical alert went out last night?
MIS 1) No issues Ed Carubis

Staff and 1) Facility update Stu Mirsky


On pm f~i n n c 7^ Niphttimp rail schfdulp Kollv McKinnoy
3) Daytime coverage schedule Rich Naeder
DOH 1) Any DOH complaints called in? Mark Foggin
Complaints
Line
DEPARTMENT OF MENTAL HEALTH,
MENTAL RETARDATION AND ALCOHOLISM SERVICES
93 WORTH STREET
NEW YORK, N.Y. 10013
212-788-5290
3fie FAX 212-788-4749
nyc.gov/dmh

SANDRA MULLIN
NEAL L. COHEN, M.D.
ASSOCIATE
COMMISSIONER
COMMISSIONER OF
PUBLIC EDUCATION AND
COMMUNITY AFFAIRS

FOR IMMEDIATE RELEASE CONTACT: SANDRA MULLIN


Tuesday, September 1<7, 2001 (212) 447-8232
(917) 578-6208

FOLLOWING THE WORLD TRADE CENTER DISASTER, THE NEW YORK CITY
DEPARTMENT OF MENTAL HEALTH PROVIDES SERVICES TO THOSE IN NEED

New York City Mental Health and Health Commissioner Neal L. Cohen, M.D., today
outlined the City's plan for meeting New York City's mental health and substance abuse
treatment needs, in the wake of the disaster at the World Trade Center.

Dr. Cohen said, "Since the tragic event last Tuesday, Department of Mental Health
(DMH) staff and I have been consulting with Federal, State, and local agencies to
ensure that immediate public health safety and mental health and substance abuse
needs are met. Within 24 hours of the World Trade Center collapse, DMH informed the
media that its mental health counseling and referral information line - LIFENET - was
up and running in English, Spanish, and Asian languages. Our Crisis Intervention staff
immediately dispatched teams to assist efforts at the Mayor's Family Assistance
Center, and at the morgue, and DMH staff covered the City's command center around
the clock.

It is now time to turn to tackling the longer term impact of this tragedy. We must make
sure that our mental hygiene system is strong and attuned to the needs of those who
will be relying upon it both for assistance in recovery, and for our traditional continuum
of services," Dr. Cohen continued.

To provide for the City's long-term mental health needs in the wake of the World Trade
Center tragedy, DMH will be implementing the following measures:

DMH will continue to staff the Emergency Command Center at Pier 92 and the
Family Assistance Center at Pier 94 on the West Side of Manhattan to make
available information, services and support. We are planning to ask DMH staff
and others in our community of providers, family members, and consumers for
their assistance in preparing for what is likely to be a long-term commitment.

- - More - -
- - Page Two - -

As soon as possible, DMH will be organizing "rest and recover" sites at the
location of the recovery effort to provide ongoing mental health and other
support services. Additional sites throughout the City will also be used for this
purpose.

Plans are being made to mobilize a city-wide response by convening several


planning meetings with the Federal Substance Abuse and Mental Health
Services Administration (SAMHSA), the New York State Office of Mental Health,
the United Way, the Coalition of Voluntary Mental Health Agencies, the Greater
New York Hospital Association, and many others. To do this, the Department will
clearly need input from staff, consumers, families and providers as we all join
together to advance long range intervention efforts that support healing and
recovery.

The Department will ensure that training is provided to mental health


professional to help them effectively assist survivors and those directly impacted
by the disaster. Training will also be geared to longer-term issues and will take
into account that all have been impacted by this traumatic episode. Soon,
training materials will be distributed to all mental hygiene agencies and
practitioners.

Special attention will be paid to the impact this event has had on children. The
Board of Education, Administration for Children's Services, State and Federal
partners, and coalitions of children's mental health services will play a key role
as we look to implement effective ways to help children cope and heal from this
traumatic experience.

With the United Way's assistance, a directory of crisis intervention, trauma, and
stress reduction services will be widely distributed.

LIFENET, the Department of Mental Health's Information and Referral line run by the
Mental Health Association, will continue to offer services 24 hours per day/7 days per
The LIFENET phone numbers are: (212) 995-5824 (for English speakers); (212) 533-
7007 (for Spanish speakers); and (212) 254-2731 (for Asian language speakers).

###
Mary Perrin - EPA press release ,..,„,,.,,,,.,, ....1................. " Page j"

From: Tom Matte <tmatte@optonline.net>


To: <mperrin@health.nyc.gov>
Date: 9/18/01 7:56AM
Subject: EPA press release

Mary - Passing thfs along for you, Jessica, et al. Evidently EPA moving
on an independent track to interpret and advise on environmental data.
Note to Jess - 1 guess this should be on the agenda for the 2 pm call.

> September 14, 2001


> EPA, OSHA Update Asbestos Data, Continue to Reassure Public about Contamination Fears
>
> The U.S. Environmental Protection Agency and the Department of Labor's Occupational Health and
Safety Administration today announced that the majority of air and dust samples monitored at the crash
site and in Lower Manhattan do not indicate levels of concern for asbestos. The new samples confirm
previous reports that ambient air quality meets OSHA standards and consequently is not a cause for
public concern. New OSHA data also indicates that indoor air quality in downtown buildings will meet
standards.
>
> EPA has found variable asbestos levels in bulk debris and dust on the ground, but EPA continues to
believe that there is no significant health risk to the general public in the coming days. Appropriate steps
are being taken to clean up this dust and debris.
>
> "Our tests show that it is safe for New Yorkers to go back to work in New York's financial district," said
John L. Henshaw, Assistant Secretary of Labor for OSHA. "Keeping the streets clean and being careful
not to track dust into buildings will help protect workers from remaining debris."
>
> OSHA staff walked through New York's financial district on September 13th, wearing personal air
monitors and collected data on potential asbestos exposure levels. All but two samples contained no
asbestos. Two samples contained very low levels of an unknown fiber, which is still being analyzed.
>
> Air Samples taken on Sept. 13th inside buildings in New York's financial district were negative for
asbestos. Debris samples collected outside buildings on cars and other surfaces contained small
percentages of asbestors, ranging from 2.1 to 3.3 - slightly above the 1 percent trigger for defining
asbestos material.
>
> "EPA will be deploying 16 vacuum trucks this weekend in an effort to remove as much of the dust and
debris as possible from the site where the samples were obtained," said EPA Administrator Christie
Whitman. "In addition we will be moving six continuous air monitoring stations into the area. We will put
five near ground zero and one on Canal Street. The good news continues to be that the air samples we
have taken have all been at levels that cause us no concern."
>
> The continuous monitoring stations will augment the ambient air quality monitoring located in Brooklyn.
EPA and OSHA will remain on site and continue to monitor for levels of asbestos, PCBs, lead and
polycyclic aromatic hydrocarbons (PAHs) in the area throughout the long weeks of cleanup ahead. In
addition, EPA will move in a bus that has the equipment to do instant analysis of volatile organic
compound samples from air at the site. It is called a Total Atmospheric Gas Analyzer and is similar to a
unit used during the Gulf War to sample emissions from the oil fires in Kuwait.
>
> The Agency is recommending that businesses in the area planning to reopen next week take
precautions including cleaning air conditioning filters and using vacuums with appropriate filters to collect
dust. Vacuuming will reduce the chance of re-entering workers tracking dust into the buildings. This work
is already underway by city agencies.
>
> The U.S. Coast Guard will be assisting EPA in monitoring impacts, if any, of today's rainstorms on the
City of New York
Comprehensive Health, Safety, and Environmental Service Plan

This is a plan for comprehensive occupational health and safety activities and environmental
health services'(e.g., water supply, food service, vector control).

BACKGROUND AND ASSUMPTIONS:


Many organizations are working at the site. All workers, regardless of organization, must receive
optimal occupational safety and health (OSH) and environmental health (EH) services.

Limited OSH and EH services are being provided at the site and not all workers are being
optimally served. These limited services will continue until more permanent services are in place.
Better control and coordination of these limited services is needed. Some of the existing services
are being provided on an ad-hoc basis (e.g., fit testing by NYCDOH) or by "volunteers", and
these services will need to be replaced by permanent services. Some existing OSH services are
adequate and can continue (e.g., fit-testing of fire fighters by NYFD).

Orders for personal protective equipment (PPE) are being placed by multiple organizations.
Ordering is not systematic and there is limited inventory control.

All organizations must commit to implementing a common comprehensive plan. A single


agency/organization is needed to coordinate all OSH activities. Some OSH services will be
performed by an organization for its own workers (e.g., fit testing for NYFD members), whereas
for other workers (e.g., construction workers) services will need to be put in place.
Environmental health services are provided for all workers in congregate settings or involve
services/activities throughout the entire site. A single agency/organization is needed to coordinate
all EH activities.

ACTIVITIES:
This service plan addresses 2 groups of services:

1. Occupational safety and health


2. Environmental health

OCCUPATIONAL SAFETY AND HEALTH


Occupational safety and health is comprised of 6 services:

1. Personal protective equipment


2. Cleaning of workers and equipment
3. Site safety
4. Hazard evaluation and control
5. Occupational medicine
6. Mental health and stress de-briefing
ENVIRONMENTAL HEALTH
Environmental health is comprised of 5 services:

1. Water testing
2. Food service inspection
3. Air monitoring (off-site)
4. Toilets
5. Rodent control
6. Vector control

NEXT STEPS A
-^-^
Occupational safety and health:
1. List all organizations (current and projected, by date) working at the site, including
numbers of workers (current and projected, by date), their daily work schedule (e.g.,
three 8-hour shifts, two 12-hour shifts).

2. Each organization will identify a contact person that can assure his/her organization's
ongoing commitment to this plan.

3. Catalog in detail existing OSH services being provided (and which will continue to be
provided) to workers by their employers. (OSH service assessment form).

4. Identify needed OSH services.

5. Request needed services.

6. Develop an implementation plan for requested services, including transition from the
existing OSH services.

7. Until a comprehensive, permanent OSH service is in place, all PPE orders must go
through NYCDOH.

Environmental health
1. Develop a map showing the location of feeding sites, drinking water, and toilets.

2. Re-locate inappropriately sited services.

3. Based on the number of workers at the site, determine EH services are adequate.
Environmental Health Safety Task List Attachment New York City Department of Health

Issue Provider Status


"e Safety
u Implement Health & Safety Plan, establish safety
parameters, conduct tool box meetings, conduct
ongoing site surveillance, provide field guidance) Bechtel Worldwide (?)
U Coordinate with FDNY Safety Battalion
U Determine resource needs
U Resources available?
D Contract or Submit Request for Assistance
U Implement (get Professional Site Safety Staff on the
ground)

HazCat
U Assess site configuration, homogeneity of debris pile,
potential hazards, etc NYC DEP HazMat
n Determine resource needs for site surveillance,
response, sample collection and analysis
n Resources available? NYC DEP HazMat
n Submit Request for Assistance
n Implement (get Hazard Characteristic personnel on the
ground)

ivironment
Industrial Hygiene
D PPE (respirators, filter cartridges, coveralls, gloves,
goggles, etc.) DOH, COSH, PESH, DOT
D Quartermaster to determine resource needs and
coordinate supply, delivery and distribution
At access points
n Establish respirator fit-testing locations
n Provide respirator fit-testing, maintenance and use
information
n Provide respirator wash stations
Worker Exposure
D Conduct worker hazard assessment DOH, DEP, ConEdison
D Implement ongoing worker exposure monitoring
program
D Establish procedure for communicating results and
decision making

Sanitation
Water
D Conduct damage assessment NYC DEP (?)
J Implement water monitoring program (if necessary) NYC DEP
D Establish procedure for communicating results and
decision making

9718/2001 page 1 of 2
Environmental Health Safety Task List Attachment New York City Department of Health

Issue Provider Status


Ambient Air
•— Develop community air monitoring protocol to DEC, DOH, EPA, DEP, Port
determine air quality impacts of disaster Authority
u Implement ongoing community air monitoring program
for contaminants of concern EPA
u Establish procedure for communicating results and
decision making

Food
U Establish full-service feeding stations at multiple
locations at ground zero perimeter
n Control food sources to the site —,
D Limit food distribution in and around ground zero
n Install hand washing facilities at all feeding stations DCAS
n Implement ongoing FSE inspection program DOH
n
Establish daily waste collection from feeding stations DOS

Pest
D Establish vigorous waste collection within and around
work site DOS
..., Bait ground zero perimeter to prevent rodent migration
into work site DOH
D Establish surveillance within work site and exterminate
as needed DOH

Vector
n Educate site personnel on standing water issues
D Establish surveillance within work site and larvicide as
needed DOH

Washdown
D Assess site configuration, access points, and personnel
and equipment flow rates DEC, USCG Strike Force
D Determine washdown station size, configuration and
location (coordinate with stakeholders)
D Determine resource needs
D Resources available?
D Submit Request for Assistance
D Implement (get washdown stations on the ground)
Personnel sanitation
r T~ Install portable toilet facilities at street corners
throughout restricted area DCAS
D Install handwashing facilities at all portable toilet
facilities DCAS
D Establish daily servicing of all toilet facilities DCAS
9/18/2001 page 2 of 2
7'r

Notice to Readers

Public Health Response to Terrorist Attacks — New York City and Washington, DC,
September 11, 2001

In response to two jet aircraft crashing into and causing the collapse of the
World Trade Center, and the subsequent, destruction of nearby portions of lower
Manhattan, the New York City Department of Health (NYCDOH) focused its resources
on the city's ability to handle the public health emergency, including an
expected influx of large numbers of patients and bodies; the safety of rescue
workers; secondary health events (e.g., smoke, dust, or chemical inhalation);
other illnesses related to the disruption of the physical infrastructure (e.g.,
waterborne disease); and mental health concerns.

In addition to the deaths caused by the impact on Manhattan's two 110-


storied structures, firefighters, police, and other emergency response personnel
were killed or injured in the immediate response to the incident. Information
from surrounding hospitals indicated that they had been able to handle incident-
related cases. NYCDOH is collecting data from Manhattan hospitals on an ongoing
basis about the number of"emergency department visits, admissions, incident-
related deaths, and staffing and supply needs. To characterize the effect on
public health, NYCDOH is reviewing medical records for all emergency department
visits to the four downtown hospitals with the largest number of incident-
related cases (e.g., number of injuries and deaths) that occurred within the
first 48 hours after the attack. NYCDOH also is monitoring visits to the
emergency departments of the four closest hospitals and Disaster Medical
Assistance Team and Emergency Medical Service triage sites. Other NYCDOH
activities include directing resources and preventing additional illnesses and
injuries.

In response to events in Manhattan and the related attack on the


Pentagon in Washington, DC, US Department of Health and Human Services activated
the National Medical Disaster System, a program that coordinates and augments
the services of federal agencies, state and local governments, and private
resources in the event of a national emergency. An urgent shipment of
Pharmaceuticals, intravenous supplies, airway supplies, emergency medication,
bandages and dressings, and other materials arrived in New York City the night
of September 11; this was the first emergency use of the National Pharmaceutical
Stockpile. The city and state of New York also received additional medical
equipment and respiratory, eye, and body protection equipment for emergency
response personnel. Federal public health personnel also worked with vaccine
manufacturers and the health departments of New York City and Washington, DC, to
ensure that adequate supplies of tetanus vaccine were delivered to each
location.

CDC has sent epidemiologists, occupational health specialists,


industrial hygienists, and other public health professionals to supplement local
efforts. Fact sheets, advisories, and public health information about this event
are being disseminated on an ongoing basis through the Health Alert Network,
which distributes information to New York City health officials in and around
the country about incident response and technical issues, and through the
Epidemic Information Exchange (Epi-X), a secured web-based system that helps
local, state, and federal public health officials report and discuss outbreaks
and other health events, particularly those suggestive of terrorism.
Department of Health
World Trade Center Disaster
Emergency Operations Center
Current Issues/Agenda
9/18/01 - 5 p m

TOPIC OUTSTANDING CONCERNS RESPONSIBLE


PARTY
Radiation and 1) Status of DOE monitoring Allan Goldberg
Monitoring Gene Mishkin
Pest Control 1) Pest control assessment below Canal St James Gibson
2) Garbage pickup below Canal St.
Food 1) Restaurants in World Financial Center Elliott Marcus
2) Distribution sites - site access problems, moved?
3) Fulton St. Market, Hunts Point Market - any problems?
4) State Health Dept and Nassau Co sanitarians arrive
tonight
Water 1) Sampling of water tanks for PCBs and asbestos Jim Luke
2) Agreement with state on water tank protocol
Air 1) Update of air monitoring on buildings Jessica Leighton
2) EPA sampling plan Kelly McKinney
3) Update on scientific panel to review and eval data
Medical and 1) Fit testing, schedule, location Sue Blank
Clinical 2) Advisories Katharine Kaye
3) Respirators inventory, distribution
4) Tetanus vaccine
5) Antiseptics and towelettes
6) Signage
7) Parent DOH Programs
Worker Safety 1) DOH recommendations updated? Jessica Leighton
2) PPEPlan Kelly McKinney
3) What is evidence of use of PPE on site?
Shelters 1) Security problems Carmen Ramos
2) Staffing Linda Moskin
Surveillance 1) Retrospective ER injury Marci Layton
2) Hospital needs assessment/casualties, by GNYHA Polly Thomas
3) Syndromic surveillance
4) Site/worker safety surveillance
5) Mental health surveillance
MIS 1) No issues? Ed Carubis

Staff and 1) Facility update - Moving back to 125 Worth? Stu Mirsky
Operations 2) Nighttime call schedule needed Rich Naeder
3) Daytime coverage schedule needed
DOH 1) Any DOH complaints called in? Mark Foggin
Complaints
Line
Shelter Client Usage

Shelter 9/17 9/17 9/17 9/17 9/18 9/18 9/18 9/19 9/19 9/19 9/20 9/20 9/20 9/21
~1A 8A 3P IIP 8A 3P IIP 8A 3P IIP 8A 3P IIP 8A
# # # # # # # # # # # clients # clients # # clients
clients clients clients clients clients clients clients clients clients clients clients
Seward Park 5 2 0 4 0 ' !
HS
Washington 28 30 40 20 26 35"
Irving HS
Fashion 44 39 55 52 45 ' "S
Industry HS
Chelsea HS 6 14 3 8 8 13

Norma Thomas 19 22 22 21 24 k ,4
HS
City School HS 4 6 2 2 7 3

JHS22 2 3 0 4 4 M-

IS 131 12 14 17 11 7 13

Comprehensive 7 6 5 8 8 L\d
Day&NightHS
Bayard Rustin Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed
HS

Curtis HS, SI Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed

Westinghouse 49 8 0 1 0>
HS, BK worker workers
NEW YORK CITY DEPARTMENT OF HEALTH
RESCUE TEAM INJURY/ILLNESS SURVEILLANCE
PLEASE COMPLETE THIS FORM FOR ANY PATIENT SEEN FOR ANY
INJURY SUSTAINED WHILE WORKING AT THE WORLD TRADE CENTER SITE NYCDOH
1. Triage person and medical provider fill out respective sections. ID#:

2. Place in drop box.


TO BE FILLED OUT BY TRIAGE
Facility: DMAT ED
DMS1 DMS2 DMS3 D Bellevue D Beth Israel
DMS4 DMS5 DMS6 D SLVincents D NYU Downtown

Triage Class: DRed 0 Yellow D Green D Black

Date: / / Time: : AM/PM Chart No.:


Last Name: First Name:
Sex: DMale D Female
DOB: / /

SPECIFIC UNIT:
FIRE MEDICAL POLICE MILITARY OTHER
QFDNY D EMS-FDNY DNYPD D Specify D Construction
D FireDept-Other D EMS-Other D Police-Other D Sanitation
D Medical Personnel (Non-EMS) D Utilities (phone/gas/cable/water/elec.
D Red Cross/Salvation Army
ACTIVITY AT TIME OF INJURY: n Other Agency (specify)
D Debris Removal D Climbing on Debris
D Cleaning/Sweeping D Other:
TO BE FILLED OUT BY MEDICAL PERSONNEL
Please check the ONE PREDOMINANT INJURY OR HXNESS from the following:
NEURO MUSCULOSKELETAL (Specify site below)
D Concussion D Sprain/Strain D Laceration D Crush
D Headache D Contusion D Abrasion D Fracture
SKIN Site: D head/neck n thorax/spine D upper ext D lower ext D multiple
D Skin irritation/rash
Q Blister PSYCH HEAT RELATED
DBurn D Psychological Stress D Heat Exhaustion
D Dehydration
CARDIO
n Chest pain RESPIRATORY E/N/T
D Cough D Eye irritation
GASTRO D SOB/Wheezing D Corneal abrasion
D Nausea/vomit/diarrhea Respirator worn? DYes DNo Eye protection worn? Q Yes D No
OTHER Asthma Exacerbation? DYes DNo
D Other

DISPOSITION
D Admitted O Transferred to D Treated and released OPied
D Other [RTISS.09.18vl.doc]
NEW YORK CITY DEPARTMENT OF HEALTH
ENHANCED EMERGENCY ROOM SURVEILLANCE
DATA ABSTRACTION FORM
fse only for patients seen with meningitis/encephalitis, botulism-like syndrome, unexplained death with fever, and
sepsis in persons > 2 years old and < 55 years old)

Hospital:
Medical record number:
Last name: First name: MI:
Date of visit: /

CLINICAL INFORMATION

Syndrome checked on Enhanced Emergency Room Surveillance Form:

Vital signs on admission: Temp: BP: HR: RR:


Summary of HPI (History of Present Illness):

Does the patient have an underlying disease? _Yes _No Unknown


If "Yes," does the patient have any of the following conditions?
Malignancy (specify: ) _Yes _No Unknown
HIV/AIDS Yes _No _Unknown
Heart disease (requiring medical therapy) _Yes _No Unknown
Chronic lung disease (e.g., COPD requiring medication) _Yes No JJnknown
Kidney disease Yes _No Unknown
Liver disease (e.g., chronic hepatitis, cirrhosis) _Yes _No JJnknown
Rheumatologic disease (e.g., SLE or RA, but not DID) "Yes No Unknown
Diabetes mellitus Yes No Unknown
Immunosuppressive/steroid therapy _Yes No JLJnknown
Other Condition (specify: ) "Yes "No Unknown

Physical examination (highlight abnormal findings):

J:\BT\Sept 15\EnhancedEDSurv_DataForm.doc Page 1 of 3 Draft3


Neurological examination (only complete for botulism-like and encephalitis/meningitis cases}:

" lental Status: ONormal OAbnormal ONot Noted (If abnormal, level of alertness:)
O Alert O Somnolent O Lethargic O Stupor O Coma O Other
Oriented to (check all that apply): O Person O Place O Time

Cranial Nerve Function: ONormal OAbnormal ONot Noted


If abnormal, please document cranial nerve abnormality and
location:

Motor Exam: ONormal OAbnormal ONot Noted


(If abnormal, please note abnormalities using 0/5-5/5 scale, if provided)
a..LeftArm__ Right Arm__ Left Leg Right Leg
b. Pattern of weakness identified: Ascending Descending Unknown

Sensory Exam: ONormal OAbnormal ONot Noted


(If abnormal, please describe:

Reflexes: ONormal OAbnormal ONot Noted


If abnormal, please note abnormalities using 0/5-5/5 scale)
a. Left Arm b.Right Arm c.Left Leg d.Right Leg

LABORATORY TESTS

CBC with differential


Collection WBC %Seg %Band %Lymph %Mono %Eos %Other Hct Hgb Pit
Date (specify: )

Chemistry
Arterial Blood Gas
Collection Date Na+ K+ cr HCO3 Glu BUN Cr PH pC02 p02 HCO3 O2Sat FiO2

Liver function
Collection ALT AST Tbili Dbili Aphos
Date (SGPT) (SGOT)

Coagulation
Collection PT PTT
Date

J:\BT\Sept 15\EnhancedEDSurv_DataForm.doc Page 2 of3 Draft 3


Was CSF collected? Yes No Unknown
If "Yes," specify:
Collection Results
Date RBC WBC %Seg %Band %Lymph %Mono %Other Glucose Protein Gram Other Culture
(specify: ) stain (e.g.,
. results? AFB,
fungi)

RADIOLOGICAL STUDIES

CXR _Yes No Unknown


If "Yes," specify results:

CT _Yes _No Unknown


If "Yes," specify:
Head Yes No Unknown Results:
Chest Yes No Unknown Results:
Abdomen Yes No Unknown Results:
Other Yes No Unknown
If "Yes, " specify type: Results:

MRI _Yes __No Unknown


If "Yes," specify:
Head Yes No Unknown Results:
Chest Yes No Unknown Results:
Abdomen Yes No Unknown Results:
Other Yes No Unknown
If "Yes, " specify type: Results:
Other Yes _No Unknown
If "Yes, " specify type: Results:

HOSPITAL COURSE
Was the patient hospitalized? Yes No Unknown
Was patient placed in/on: _ICU Ventilator
Is patient: Alive _Dead

Final diagnosis:
Are other family members or friends ill with the same syndrome? Yes __No Unknown

J:\BT\Sept 15\EnhancedEDSurv_DataForm.doc Page 3 of 3 Draft 3


New York City Departments of Health and Mental Health
DAILY CLIPS
Tuesday, September 18, 2001

Page Article Publication

1-2 Donors Flood Banks, But a


Steady Stream is What's Needed The New York Times

3-4 During Traumatic Times, Small


Acts Can Bring a Measure of Comfort The New York Times

5-6 Dust is a Problem, But the Risks Seem


Small . The New York Times

7-8 Help & Hotlines New York Post


The New York Times, Tuesday, September 18, 2001

Donors Flood Blood Banks,


but a Steady Stream Is What's Needed

health officials estimate that 5 per- blood from Germany, the Nether-
„< By LAWRENCE K. ALTMAN, M.D. cent of them actually do so. And be- lands and Switzerland by 2005. That
cause many major cities are not self- effort became more urgent recently
When Americans learned of last sufficient in blood, collections are re- when the Food and Drug Administra-
^week's terror attacks, tens of thou- distributed around the country. tion issued rules that could soon ban
jsands —15,000 in New York City The New York Blood Center, which the use of blood collected from peo-
»alone — donated blood. , . provides about 80 percent of the- met- ple who spent-three months or more
1J& With few survivors, only 600 units ropolitan area's blood needs, imports in Britain f roni 1980 to 1996, or five
'jjwere needed for casualties, so the: ; about 30 percent of the 600,000 units r years or more in Europe since 1980.
*glew York Blood Center asked those • it uses each year. About a fourth of - The aim is tp prevent the theoretical
in line to return in the^weeks ahead. the'blood comes from Europe and 5 •': spread of the human form of mad
;jBut will they? Will they roll up their percent from elsewhere in the United :;; cow disease.'The fact that no blood
'sleeves when the need for blood is not States. V . could arrive from Europe last week
a national emergency, but merely a Critics have long said the problem underscored the fragility of depend-
lies not with the public, but with un- ing on foreign supplies.
matter of life and death? friendly employees and the inepti- Blood banks also need to match
Few people realize that blood is . tude of blood banks. Last week, few their stocks of donated blood with the]
perishable and cannot be stored in- donors complained about long lines :. types needed by their patients. Be-
definitely. Blood centers function at donation sites. Because the city cause the percentage of each blood
; more as pipelines than banks, and was essentially closed, the wait al- /type varies among ethnic and racial
.there is a steady need for donors. ., lowed people to release their anger - groups, blood banks must strive to
-?f Operators of the'nation's blood and to talk, even to strangers! , V - match the donor and patient pools in
%anks wondjetwhy they have fallen But many are not so patient ordi- ' meir areas;: ;:P^\,;;•,;:;:$^J;|:;':i
|so short in meeting demand during narily. Acknowledging such prob-, ... Manufactured substitutes for red
• formal times, and how they can capi- lems, Dr. Robert L. Jones, the chief - blood cellSj'Which are being tested in]
on toe altruistic spirit shown executive officer and president of the clinical trials^ have been hailed for j
eek._Margerpool of donors New York Blood Center, said that ; :their potentisj to relieve the blood -:?
helplhem provide blood, for improved management techniques . .shortage because theyfniay be^ able •
^ytp cancer patients, heart had helped his center collect 90,000 to be used to provide transfusions fo
ts heeding transfusions after more units a year since 1998, when he trauma patients and those undergo-'
ypass surgery and arthritis pa- came to the blood center,, .^ /'• ' ~irig certain kinds of surgery. But no
Hientsjiaving joint replacements Hoping, to become self-sufficient, substitute has been licensed in this
* Thevnumber of Amencans eligible the blood center in 1998 began pre- country, and even the best would; ^
*to donate blood is not known, but paring to end the importation of .. have limited use because theeffec-1
The New York Times, Tuesday, September 18, 2001

it, in the wake of last week's flood of


donations, some blood centers may
have to discard some of the blood
they collected because of its limited
shelf life, Dr. Jones said.
Medical advances have increased
the need for blood products and re-
duced the number of eligible donors.
For example, cancer treatment has
improved but transfusions are often
needed to offset the unwanted effects
of treatment and the disease. Also,
the pool of potential donors has
shrunk because scientists have de-
veloped tests to detect H.I.V., hepati-
tis C and other viruses that can be
transmitted through blood products.
Doctors have become more judi- -
cious in prescribing transfusions,
and patients have been urged to self;
donate blood before surgery. Self-do-
nations account for 10 percent of .
Richard L. Harbus for The New York Times
New York City's supply, but much of
what is not needed for donors cannot
Heidi MacDonald donated blood on Wednesday in New Rochelle, N.Y. be given to other patients because ',
In New York City, 15,000 pints were donated after the terrorist attacks. the donors carry viruses or have ail-
ments that could be dangerous.
tiveness generally is short-lived. lets is five days and for red cells 42 Many of the people who gave blood
Also, red cells cannot perform the days. So until new preservatives are last week were donating for the first
time. Dr. Jones said he hoped to turn
function of blood products Me plate- found, a steady flow of blood donors them into regular donors. Success in
lets and other substances in the blood will be needed instead of the surge New York Gity and elsewhere would
that allow it to clot when needed. that followed last week's disaster. go a long way in avoiding future
The maximum shelf life for plate- Though they are reluctant to admit shortages.
The New York Times, Tuesday, September 18, 2001

During Traumatic Times,


Small Acts Can Bring a Measure of Comforl

get on with our lives, which we know ic events of Sept 11 will bring back '
ByJANEE.BRODY will never be the same. memories of previous traumas that
"People should realize that re- may have been buried for years and
On Wednesday, reeling from the sponses of depression, grief, anxiety now must be relived, according to '
unfathomable tragedy of the previ- are to be expected and accepted," Dr. Rosenheck, who counsels veter-
' ous day, my husband baked bread, said Dr. Herbert Pardes, a psychia- ans as director of the Veterans Af-
cooked comfort food and invited two trist and the president of New York fairs Northeast Program Evaluation
.single friends to supper. Presbyterian Hospital. "Our securi- Center in New Haven.
J. We talked for hours about what ty has been penetrated and that is
Hjad happened, an event that has very threatening. A roster of con- Talking Helps
tshaken most Americans to the core, cerns will come up: will I be able to
• get on a plane or walk near a famous Don't let anyone tell you to try to
;and about what further tragedies
landmark?" forget about it, to stop looking at the
may unfold in the days ahead as the television, listening to the radio,
gfiill extent of the disaster becomes Whether it was a friend, relative,
colleague, total stranger or the sym- reading the papers and talking about
Known. Similar discussions have tak- bol of the twin towers that were the this disaster. Don't listen to people
en place during my morning walks World Trade Center, we have all lost who say that thinking about it simply
and bike rides, in the Y.M.C.A. locker someone or something. perpetuates the pain and insecurity.
room, grocery store and playground, Even for those not directly touched Psychiatrists and other counselors
in the office and on the street. by the loss of a loved one in the . say otherwise.
' "We all have a natural reflex to events of Sept. 11, "the fallout can go They have learned from the expe-
tiuddle, and things like this can be- on for months or years," said Dr, rience of Vietnam veterans that try-
come occasions for reunion and heal- Flemming Graae, director of child ing to suppress horrible memories
ing," said Dr. Robert A. Rosenheck, and adolescent psychiatry at New only makes them worse; they even-
a psychiatrist, affiliated with Yale. York Presbyterian Hospital in White tually come back to haunt you in
.Now, a week .later, conversation still Plains. "Everyone is affected to ways that are harder to recognize
comes back to these horrific acts of some degree, responding with hor- and treat. Rather, Dr. Rosenheck .
terrorism, acts that have under- ror, anxiety and empathy. Especially says, talking about the'nightmare of
_mined our basic assumption that in for children, these events can leave a Sept. 11 is helpful, cathartic and heal-
'•this country we are safe from war lasting imprint. They will reshape ing, f-t
-And external attacks, as Dr. Rosen- how we think about ourselves and the These events graphically tell us
lieck put it We are all trying to inte- world, our community and our Safe- "not only that the world is not safe
grate what has happened, to assuage ty-" but that basic things are missing,"
'the pain and anxiety and find ways to And for some people, the traumat- Dr. Rosenheck said. "The mind now
The New York Times, Tuesday, September 18, 2001

has to work hard to think about it and cord grapes from our yard and put Presbyterian in White Plains.
reconstruct the world with those them out on the sidewalk, inviting Adults should go to work, and chil-
pieces missing. People need to sit people to "sweeten the sorrow." The dren should go to school, play dates
with their families and friends in grapes were gone in a few hours, and and sports activities. At the same
front of the TV and talk and put the passers-by left notes of gratitude. time, however, he said families must
pieces together." It is also important to be a good lis- individually determine what is the
It is also healing to do something to tener to people who are suffering, right thing to do and when. Is this the
help those who have suffered the said the Rev. Frank Geer, an Episco- time to take a long trip? Will flying
most from this tragedy, and that in- pal priest who is director of religious cause undue anxiety? On the other
cludes rescue workers as well as the services at St. Luke's-Roosevelt Hos- hand, driving to the country, taking a
families and friends of those who pital and rector of St. Philip's Church hike in the woods, visiting the shore,
died. This kind of disaster makes . in Garrison, N.Y. Father Geer spent going biking or fishing with the chil-
people feel impotent, and finding two days listening to the stories of dren and similar activities can be
ways to help others can restore a rescue workers and medical person- very restorative.
sense of competence and control. nel who were at the scene and needed
The very day of the disaster, many to talk about what they had seen. Avoiding Overreaction
thousands of people lined up to give - "People need to tell their story
blood, so many that hospitals ran out over and over again, and every time Dr. Rosenheck warned against '
of equipment. The Community Book- they tell it, it brings further cathar- misplacing one's anger over this" '.
store in my Brooklyn neighborhood sis. So be a compassionate listener," event. He said: "Trauma can elicit
. began a drive for materials —from he pleaded. "Even my wife and great rage. When we lose part of our-
aspirin and alcohol to blankets and daughter wanted to hear what it was selves, there is a natural aggressive
tents — needed by the rescue work- like for me. Sharing the burden is reaction. In Vietnam the trigger for^
ers, the families of firefighters who healing." atrocities against innocent civilians
died and the people who have been President Bush, in his initial talk was not a hatred of the Vietnamese,
displaced from their homes. Scores to the nation, expressed his desire but the loss of comrades killed by an
offpeople responded. that the country show the perpetra- enemy that could not be seen and ^
Even little gestures can bring sol- tors that it cannot be brought down fought." -----'? ".,'..-",i,u :-~:<-f;:.•,.*"-
• -ace to the givers as well as the recipi- by terrorism. Psychological experts In the aftermath of the current
ents. One youngmother rode her bi- agree that it is important to resume tragedy, "there is the danger of reac-
cycle across the Brooklyn Bridge on normal life as soon as possible. tion in ways that will later be regret-
Wednesday to bring food Jo police of- "We should reinforce the aspects ted," he said. "There is a call for .;,
ficers on rescue duty My-husband of daily life that help us feel safe and vengeance, when what we need is to;
and I picked about 50 pounds of Con- secure," said Dr. Graae of New York be led to react responsibly."

4-
The New York Times, Tuesday, September 18, 2001

Pust Is a Problem, but the Risk Seems Small


By ANDREW C. REVKIN

As thousands of workers
reamed back into Lower Manhat-
rt yesterday for the first time
ice the terrorist attacks, federal
ficials said they faced no signifi-
uit health risk.
Low levels of asbestos were de-
cted in some dust and debris close
the wreckage of the World Trade
;nter, the officials said, but there
as no evidence of danger, except
1 search crews moving the rubble.
•''We haven't found anything that
^alarming to us," said Mary
ears, a spokeswoman for the En-
ronmental Protection Agency.
As an extra precaution, officials
icommended that businesses in the
•ea clean the filters on air-condi-
>ners and use vacuum cleaners
luipped with filters for fine parti-
es — those labeled HEPA — to
raid scattering any hazardous
ist.
^Officials recommended similar
:e<""itions for apartment dwellers,
i\y should use vacuums
jth particle filters, mop floors and • Justin Lane for The -New
ie wet cloths to dust, and wash The workers vacuuming up dust in Lower Manhattan needed to wear protective masks and spec:
pthing soiled by the ash and dust
jparately from other laundry.
Over all, though, officials said, the ;Agency officials and independent "A dead body is not going to give For residents and people working
ily significant health risk re- experts tried to quell rumors about you a disease," said Dr. Paul Blake, nearby, the air appeared to present
lained near the destruction. Work- other hazards, including the possi- the state epidemiologist for Geor- little risk, officials of the Occupa-
is there should wear masks and bility that the fires might have gia. Dr. Blake, who was chief of the tional Safety and Health Adminis-
rotective gear and clean their turned freon from air-conditioners enteric diseases branch at the fed- tration said. The agency sent crews
toes before heading home, they into a poisonous gas called phos- eral Centers for Disease Control and around the financial district late
lid. gene. - Prevention, added, "You have a last week wearing small devices
Some officials expressed frustra- The chemical reaction that gen- multiplication of bacteria in decom- that sample air and found no signifi-
?n because many of the workers — erates phosgene is possible in ex- posing bodies, but they are the same cant signs of asbestos. Other tests
lost of them hard-bitten construc- tremely hot flames, but not in fires bacteria we all have within us, in
bn workers — were ignoring their like those still burning, agency offi- our bodies and on our skin." p. (.,
icommendations. cials said. Any gas generated by the To try to catch any surprises, the
•"In the early hours of a rescue,. initial inferno has dissipated, they Environmental Protection Agency
ie urgency ot these efforts leads said. deployed monitoring and testing
Kjple to forget their own health and When rescue crews prepare to equipment around Lower Manhat-
itety," said Dr. Meal L. CohenT enter buried pockets where survi- tan over the weekend, including a
ew York City's health commis? vors might be found, they generally mobile laboratory used during the
oner. The city will add more safety* test the air for organic compounds Persian Gulf war to check for gas
'ficials to its teams this week, he' like freon, which can be suffocating or biological attacks, officials said.
ud, to make sure tnat more because it is heavier than air and There were no signs that the at-
iarchers wear protective attire. can build up in pockets, officials tackers had dispersed any toxic
Tina Kreisher, a spokeswoman^ agents, officials said, and the lab-
ir the E.P.A., said that ample gear said. Suspect air samples are sent oratory was focused on identifying
as available at the attack site but to a mobile laboratory for analysis. conventional kinds of pollution.
lat because of the heat and stress, Dr. Cohen said that continual Many dust samples collected near
brkers commonly refused, it. monitoring of the crash site and the attack site last week contained 1
;"There are small pockets of as- rubble with Geiger counters had percent to 2 percent asbestos, agen-
y-~." Ms. Kreisher said. "The turned up no evidence of radiation, cy officials said/That concentration
1 a is there — not for the city, which might be emitted, for exam- is not high enough to create a short-
)t tor residents, but definitely for ple, from medical X-ray equipment term risk of lung disease, the offi-
lese workers." Many workers may destroyed in the attacks. cials said. Nonetheless, the agency
2 there for months, she said. Many officials and experts added sent 10 trucks into the area over the
^Federal officials said they would that the decomposing bodies of vic- weekend equipped with filtered vac-
;t up at the site equipment able to tims of the attacks posed no danger. uums that suck up contaminants
can 1,500 workers twic6 a day. without spreading them.
The New York Times, Tuesday, September 18, 2001

were done for air inside buildings in Mount Sinai School of Medicine, gen-
the financial district. erally agreed with the federal offi-
"Our tests show that it is safe for cials' views, adding that rescue
New Yorkers to go back to work," workers who did not wear protec-
said a statement from John L". Hen- tive gear ran the highest risk.
shaw, the assistant secretary of La- Dr. Landrigan, who has often
bor for occupational health. "Keep- worked to highlight health dangers
ing the streets clean and being care- in the environment, said the public
ful not to track dust into buildings faced little risk. "People who live in
will help protect workers from re- Lower Manhattan and who work
maining debris." there are certainly going to be ex-
Over the weekend the Environ- posed to dust," he said. The dust,
mental Protection Agency parked from pulverized building materials,
five air sampling systems near the could cause bronchitis or asthma
crash site and put another one on attacks in children or vulnerable
Canal Street to monitor any drift . adults, he said.
uptown. The systems will measure "But having said all that," he
asbestos, lead, PCB's and other added, "I don't think we are looking
harmful compounds • during the at a situation that is in any way life-
cleanup, agency officials said. Other threatening."
samples were being taken at estab- Some office workers were taking
lished pollution monitoring stations no chances. One woman rode the
in Lower Manhattan and Brooklyn. commuter train from Westchester
Dr. Philip J. Landrigan, the chair- County yesterday morning carry-
man of the department of communi- ing a personal air-filtering machine
ty and preventive medicine at the for her office in the city.
ATTACK ON AMERICA

HELP & HOTLINES


MISSING PERSONS
HELP US TO HELP YOU.
To provide you with a reliable
source of information. The
The Justice Department's
Office of Victims of Crime
hotline (800) 331-0075
ARMY personnel (800) 984-
BLOOD DONATIONS
The Red Cross reports that it
does NOT need any more
BENEFTTS
Call the Social Security
The Red Cross: (800) HELP-
NOW or www.nyredcross.org
(credit cards). Or mail check
to American Red Cross
TWA
Flight status for TWA and TW
Express (800) TW-FLIFO or
www.TWA.com
CD

8523 or (703) 428-0002 blood donations for the time Administration for survivor Aero Mexico
New York Post has set up its being. Call (800) GIVE-LIFE Disaster Relief Fund, P.O. Box
own Missing Persons list NAVY (877) 663-6772. and disability payments: 3756, Church Street Station, (800) 237 6639
AIR FORCE: (800) 433-0048. for current requirements. (800) 772-1213, www.ssa.gov www.aeromexico.com
After posting your New York, N.Y. 10008.
information on our Web site, DEPT. OF DEFENSE The Silver Shield Foundation: Air Jamaica T)
www.defenselink.mil/news/ If you still want to donate All flights back to normal O
volunteer staff will contact VOLUNTEERING (212) 499-0866 - collecting
releases/html blood, call America's Blood (800) 523 5585
you to verify the specifics. funds for the educational
Centers at (888) BLOOD-88 to needs of firefighters/police www.airjamaica.com
Gotonypost.com. get an update.
Or you can drop photos or Javits Center's Volunteer widows and children. Silver British Airways
FACILITIES FOR RESCUE Coordination Center, llth (800) Airways
c
fliers with a Post Shield Foundation, 420 o
WORKERS Avenue at 35th Street, does www.british-airways.com C/5
representative stationed just INSURANCE COVERAGE not need any more
Lexington Ave., Suite 2320,
outside our main entrance at New York, N.Y. 10170. Delta Airlines
1211 Sixth Ave. (between Free massages at the Soho volunteers today. Check status of flight at
Herbs & Acupuncture walk-in For victims of the WTC New York State Volunteer www.delta.com or by calling
47th and 48th Streets) from disaster, Insurance AIRLINE HOT LINES GO
10 am to 2:30 p.m. and we clinic, 10 a.m.-8 p.m., 580
companies have set up
Hotline: (800) 801-8092. (800) 325 1999 a>
1 will put them up on Broadway, Suite 607, (212)
219-2887. special 24-hour numbers. 1 To find out the current status Updates on AIR TRAVEL:
nypostcomforyou. of giving general assistance National Airlines
Crunch Fitness - use of wwwfly.faa.gov Updated flight information
facilities for rescue workers. State Department of to the American Red Cross, cr
via Other sources for missing call (800) HELP NOW. (888) 314-5387 or
One location, 404 Lafayette Insurance: Offices at 25 Passengers departing from all www.nationalairlines.com
persons:
St. between 4th St. and Astor Beaver St., are open. Hotline: U.S. airports should plan to United Airlines
Greater New York Hospital (800) 339-1759. Two outreach
Association (GNYHA) Place, will be open 24 'hours, DONATIONS arrive at the airport a Operating reduced schedule.
www.nyc.gov centers are in White Plains, minimum of two hours prior Check flight status on
at 75 S. Broadway (across to departure. www.united.com
City hotline for relatives of from Westchester Mall) and The TWIN TOWERS FUND O
missing people: (212) 560- (212)614-0120. Airlines are asking for paper United automated flight O
in Mineola, 200 Old Country established by the City of tickets or E-ticket receipts
2730, (212) 741-4626 New York Health and Racquet New York to assist the I information (800) 824 6200
Road, (516) 248-5886. and photo ID. I United Reservations (800) 241
A Families of Missing Persons Club on Whitehall & Water families of NYC policemen,
Center is located at Pier 92 Streets open for rescue Chubb: For everything except 6522
workers compensation, call firefighters and rescue Air Canada
on the West side, at 52nd St. workers, for showers and (800) 252-4670; Workers workers; Checks payable to
NYPD: (718) 677-8238 chair massages, (212) 269- Operating most domestic and
Comp., call (800) 699-9916, The twin Towers Fund at all Internal Flights- HOUSING
FDNY: (718) 999-2541 9800 General Post Office, P. 0. Box
www.chubb.com www.aircanda.com
EMS: (718) 609-9216 American Lung Association; 26999, New York. NY 10087-
Port Authority: (973) 642-0165 (800) LUNG-USA State Farm: A temporary office America West Airlines BATTERY PARK CITY
in an RV will process claims 6999 Operating all major flights.
Body Maximus Health Club, 90 The New York State World For news and information
WTC companies: and issue checks, at 310 W. Standby travel available. If related to Battery Park City:
John St., is offering use of all Trade Center Relief Fund
Morgan Stanley: (888) 883- facilities, including showers Broadway. 7 a.m to 7 p.m. Or flight has been canceled call http://bpc.mobilel23.com
call: Auto and Home claims, Make a donation with a reservati9ns, (800) 235 9292.
4391. and beverages, (212) 732- credit card on Red Cross shelters,
(800) 372-5246; Life, (888) www.americawest.com www.nyredcross.org.
Commodity Futures Trading 4445
464-5433; Workers comp, • www.state.ny.us or by (American Airlines Citi Habitats Emergency
Commission: (800) 765-3277 (800)592-8411, calling (800) 801-8092. Or
Empire Cross/Blue Shield: - * Flight Status for American and Housing Help Center is open
S.O.S. statefarm.com send a check to the Fund, American Eagle is available
(866)761-8265 ' P.O. Box 5028, Albany, N.Y. 9 a.m.-8 p.m. through
Travelers: Two catastophe by calling (800) 223 5436 or Wednesday to help those
Pitney Bowes: (800) 932-3631 response vehicles set up at 12205.
Carr Futures: (800) 755-7620 New York Cares New York and wwwAA.com displaced find temporary
388 Greenwich St. Or call for The United Way: A fund to aid
Kemper Insurance Co.: (800) New Jersey agencies victims and families: The accommodations. Some are
622-9966 collecting relief donations annuities, (800) 842-5642; free, others cost a nominal
workers comp.,-(800) 842- September llth Fund, United
Fuji Bank: (888) 537-3854 and supplies: fee. Call (212) 685-7777 or
0240, www.travelers.com Way, 2 Park Ave., New York, (877) 692-4663
Cantor Fitzgerald: (212) 940- www.nycares.org N.Y. 10016, (800) 710-8002, or
8162/8482/8492, 893-6073
Hartford: For property,
-
The National Association of Gateway Cplocation Free FRIENDS Inc* a Bronx
Realtors has created the space to its displaced clients nonprofit, with Visiting Nurse
Realtors Housing Relief Fund and companies requiring a AMTRAK TRAINS
Services of New York, for
with a beginning donation of data center in the www.Amtrak.com
Mott Haven victims and
Slmillion for mortgage and metropolitan area. Talk to families, between 9 a.m. and
rent payments for victims Adam Brodsky, (212) 446- 6p.m., (718) 401-6603.
and their families, including 9029. Maimpnides Medical Center
MAIL DELIVERY
fire, law enforcement and Human Resources Crisis Counseling hotline:
emergency personnel. Go to Administration (HRA) People whose Post Offices are
www.realtor.com (718)283-8426
Information regarding food Safe Horizon victim assistance closed (Bowling Green,
stamps, Medicaid and program: (800) 621-HOPE or ' Church Street, Wall Street)
LEGAL HELP housing, call (877) 472-8411. (212)577-7777. can pick up mail at the James
Westchester County Office of A. Farley Building side lobby,
Economic Development Help 380 W. 33rd St.
NYC Bar Association will waive companies find temporary TOURISTS
its consultation fee to Space, (914) 995-2926,
victims and their families www.westchestergov.com Tourists and travelers who are
SCHOOLS
who seek legal advice
regarding insurance and stranded should call the New
York City Tourism Board at OPEN: Murray Bergtraum HS,
estate planning, (212) 626- STRANDED PETS (212) 484-1222 for help in next to Police Plaza, will re-
7373. o>
finding food, housing etc. open on Thursday.
Queens County Bar The Humane Society of the
Association will help They should also contact
United States (HSUS) offers their embassies or REASSIGNMENTS:
attorneys locate space in assistance to people who Students at eight schools in o
member offices: (718) 291- consulates in New York or
know about pets whose Washington. the vicinity of the WTC have FT
4500. been reassigned.
owners are missing, (718) The New York City Tourism
New York State Bar 272-7200, www.hsus.org Schools are closed today and "C
Association (NYSBA) hotline Office, at 810 Seventh Ave. at O
For missing pets, Pet Rescue 53rd Street, is open to assist tomorrow for Rosh on
for displaced lawyers and hotline, (212) 876-7700. Hashanah; the following
their clients: (877) HELP-321. stranded travelers with the
there's also a lost pet center * latest information. changes begin Thursday H
at the corner of Varick and
King Streets. FBI TIPS Stuyvesant High School go to n
AID TO BUSINESSES Brooklyn Technical HS, 29
The FBI Web site and phone Fort Greene Place, 11 a.m.
Displaced businesses call a COUNSELING number where people can High School for Leadership
hotline, operated by NYC report information about the and Public Service go to
officials: (212) 621- New Yorkers Share: WTC terrorist attack: Fashion Industries HS, 225 W.
ft)
9502/9517/9527 or email Professional counseling for www.ifccfbi.gov and (866) 24th St., 9a.m.
spacebank@rebny.com. 483-5137 or (800) 331-0075. a
displaced persons at RFK High School of Economics and
Federal Emergency Genesis Apts:, 113E. 13 St. They are eager to recover any Finance to Norman Thomas
Management Agency (bet 3rd ft Uh\! .— videos that tourists may HS, 111 E. 33rd St., 9a.m.
(FEMA), help with funeral TJatioflal Mental Healtti "1 have been shooting before PS 89 and PS 50 to PS 3,490
expenses, low-interest loans Association (NMHA). The ' and during the attacks. Hudson St., 8:40 a.m.
to replace personal property, oo
Mental Health LifeNet phone EMERGENCY 911 IS 89 to IS 70,333 W. 17th St.,
unemployment assistance, numbers in New York City 8:40 a.m. to
including self-employed: are (212) 995-5824 (English), PS234 to PS 41,116 W. llth St., o
(800) 462-9029 (212) 298-3373 (Spanish), PLEASE DO NOT use 911: The 8:40 a.m.
o
CoStar Group is offering (212) 254-2731 (Asian). | police missing persons PS 721 to P 79M, 55 E. 120th St,
access to its extensive Department of Mental Health , inquiry line is (212) 560-2730 Manhattan, 9 a.m.
database of New York area -5000
— — ii»,ww.v*.ifc/ tn^-JUUU
leasing brokers and
available office properties in
FDNY Family Crisis Center; TRANSPORTATION If you have any
(718)352-2140.
the city. Visit the Empire City University of New York
information that would
State Development Web site, (CUNY) Service is staffed by CommuterUnk, a nonprofit, help our New York
www.nylovesbiz.com and commuter assistance with
volunteer faculty in
information and carpools,
community, please send
select the NY site Finder psychology, social work and
link. Then click on World (866) NYC-OMMUTE, details by fax to (212)
nursing: (212) 794-5588.
Trade Center Disaster The Port Authority has opened www.commuterlink.com. 930-8681, or email to
Alternative Space Listings. two family assistance' New York State: Access to helphotline<§>nypostcom
(800) ILOVE NY. centers for employees and assistance services by State
To obtain Information from a agencies, 800-lLOVENY (800-
families. At JFK, call (718)
clearinghouse of available > 751-8200; at Newark, call 456-8369)
office space, www.stanton- (973)642-0165.
crenshaw.com/clearinghous Jewish Board of Family and Reservations for ACCESS-A-
e.html, or email RIDE PARATRANSIT SERVICE
Children's Services has set
alex@stamtpm-crenshaw.eom may only be made one to two
up drop-in centers in all five
boroughs, (212) 397-4090. days in advance of the day of
travel by calling (877) 337-
2017. Access-A-Ride cannot
travel into lower Manhattan
Prepared on September 18, 2001

WTC Surveillance Systems Summary

Overview of Surveillance Programs:

1. Retrospective Emergency Room- Review of medical records from four hospitals in close
proximity to ground zero for frequency and types of injuries seen during the interval
9/11-9/13.
Team Leaders: Susan Wilt (NYCDOH) & Mike Bell (CDC)

2. Rescue Team- Involves the four lower Manhattan hospitals and the DMAT site treating
rescue workers. Focuses on injury and illness occurring in any individual working at
ground zero (includes EMS, Fire, Police, construction, etc.)
Team Leaders: Mike Phillips (NYCDOH) & Sandra Berrios (CDC)

3. Svndromic- A monitoring system of eleven syndromes at 15 sentinel hospitals for


detection of a biologic agent release.
Team Leaders: Sharon Baiter (NYCDOH)& Brad Winterton (CDC)

4. Hospital Assessment- Daily reports on ED visits and admissions stratified by those


related to the WTC incident. Surveillance is conducted by the Greater New York Hospital
Association in coordination with NYSDOH & NYCDOH

File name is "Combined report for 9-17-01"


W:Apps/Pdox40/worldtrade/reports/Intemal
Prepared on September 18, 2001

1. Retrospective Emergency Room

(This report includes data from preliminary descriptive analyses that will change as data are
further refined. Approximately 90-95 % of data on 4 hospitals have been entered and are
presented in this report. Data verification is ongoing.)

Background:
Emergency department (ED) care during the acute phase of the disaster response was assessed
retrospectively to understand the types and quantities of injuries caused by the WTC attack, the
categories of individuals affected, and the impact on healthcare facility resources and capacities.

Based on early statistics provided by the New York City Department of Health (NYC DoH) and
the Greater New York Hospital Association, four hospitals are believed to have provided the
majority of disaster-related care in Manhattan during the first days following the attack. This
assessment focuses on these four hospitals, however additional facilities may be assessed if
deemed appropriate by NYC DOH.

Facilities assessed:
Saint Vincent's Hospital* - near completion
Bellevue Medical Center* - near completion
Beth Israel Medical Center - near completion
NYU Downtown - near completion
Cornell Medical Center (Uptown) - ongoing abstraction, no data entered

Time frame:
0800, 11 September 2001 through 0800, 13 September 2001

Information sources:
ED encounter forms
Patient charts
ED registration logs
Hospital admissions logs

Data were gathered on-site at each facility on 14 and 15, September, using a standardized data
abstraction form (appendix 1).

Descriptive Information:

Number of patients: 1322


Female: 472 (37%)
Median age: 39 years (range 1-97)

File name is "Combined report for 9-17-01"


W:Apps/Pdox40/worldtrade/repo its/Internal
Prepared on September 18, 2001

Table 1 A-Emergency Department Diagnoses


Total Saint Bellevue Beth NYU-
Vincent's Israel Downtown
N (%) N (%) N (%) N(%)
Respiratory (all) 412 112 77 87 136
(27) (19) (21) (33)
Respiratory (smoke inhalation) 340 66 52 87 135
(19) (15) (26) (40)
Trauma 346 106 84 82 72
(31) (24) (24) (21)
Ophthalmologic 182 75 50 33 24
(41) (28) (18) (13)
Cardiac 77 32 10 23 12
(42) (13) (30) (16)
Gastrointestinal 56 20 10 18 8
(36) (18) (32) (M)
Burn 18 9 4 3 2
(50) (22) (17) (11)
Obstetric/Gynecologic 16 0 1 11 4
(0) (6) (69) (25)
Infection 26 10 8 7 1
(39) (31) (27) (4)
Psych 98 35 16 37 10
(36) (16) (38) (10)
Diagnostic categories above include individuals with more than one diagnosis. Categories therefore overlap.

Table IB-Trauma Sub-types


Sub-type N
Laceration 128
Contusion 101
Sprain/Strain 110
Fracture 37
Crush 10

Table IC-Outcomes of ED visits


Total Saint Vincent's Bellevue Beth Israel NYU-Downtown
N(%) N(%) N (%) N(%)
Admitted to 48 48 54 37
188
Hospital (26) (26) (29) (20)
Discharged 306 191 252 276
1026
Home (30) (19) (25) (27)
Died in 1
2 1 0 0
ED
Unknown 2 4 12 72
90
(2) (4) (13) (80)

File name is "Combined report for 9-17-01"


W:Apps/Pdox40/worldtrade/reports/Interna]
Prepared on September 18, 2001

2. Rescue Team
Multiple categories of rescue workers are on the WTC site, operating in a hazardous
environment. The purpose of this prospective surveillance is to determine the type of injury and
illness, type of worker injured, time and date of injury or illness and disposition of the injured
worker. A rescue worker is defined as anyone working at the WTC site. Four hospital
emergency departments and the DMAT facility provide the majority of emergency medical care
to workers.

Facilities assessed:
Bellevue ED, Beth Israel (Petrie Division) ED, New York University Downtown ED, St
Vincent's ED & Disaster Medical Assistance Team sites (DMAT)

Table 2A-Total Number of Visits, by Facility


Facility Number of Rescue Workers
visits
Hospital ED 153

DMAT 202

Total 355

Table IB-Injury Type at All Facilities, by Day


Injury Type 9/14/01 9/15/01 9/16/01 9/17/01 Total
Smoke/Dust Inhalation 12 14 10 9 45
Skin Irritation/Rash 4 9 2 2 17
Sprain/Strain 23 14 9 9 55
Abrasion 0 1 2 3 6
Laceration 6 10 5 7 28
Contusion 2 6 1 2 11

Crush 0 1 0 1 2

Fracture 1 1 2 1 5
Burn 0 0 2 0 2
Concussion 0 1 1 0 2
Eye Injury 15 12 21 11 59
Psychological Stress 1 2 1 3 7
j

Other (See Table 3) 23 34 32 21 110


Unknown 0 1 1 2 4

File name is "Combined report for 9-17-01"


W:Apps/Pdox40/worIdtrade/reports/Intemal
Prepared on September 18, 2001

Table 2C: Other Injuries Most Frequently Reported


Injury Types Frequency

Blisters 12

Headache 11

Chest Pain 9

Asthma 8

Dehydration 5

Diabetes 4

Needed Medication 4

Exhaustion - 3

BP Check 3

Musculoskeletal/Other 3

URI 3

Hypoglycemia 2

Old Burn Injury 2

SOB 2

Syncope 2

Table 2D: Type of Rescue Worker Evaluated at All Facilities, by Day


Type of Rescue Worker 9/14/01 9/15/01 9/16/01 9/17/01 Total

Fire 14 13 11 15 53
Police 24 33 30 25 112

Medical 8 7 8 0 23
Construction 10 10 16 9 45
Military 2 13 3 1 19
Red Cross 2 2 0 0 4
Other (See Table 5) 26 26 17 17 86
Unknown 2 2 4 5 12

File name is "Combined report for 9-17-01"


W:Apps/Pdox40/worldtrade/reports/Intemal
Prepared on September 18, 2001

Table 2E: Other Rescue Worker Most Frequently Reported


Other Rescue Worker Frequency

Volunteer (not specified) 40

Animal Search & Rescue 3

OEM 2

Rescuer (not specified) 2

Table 2F: Number of Injuries, by Injury Type and Rescue Worker Type
Fire Police Medical Construction Military Red Cross Other Unknown

Injury Type
Smoke/Dust 11 16 2 1 1 0 13 1
Inhalation
Skin Irritation/Rash 1 3 2 1 1 0 9 0

Sprain/Strain 7 18 4 9 2 0 13 2

Abrasion 2 2 0 1 1 0 0 0

Laceration 4 14 0 5 1 1 3 0

Contusion 2 6 1 0 1 0 1 0

Crush 0 0 0 1 0 0 1 0

Tracture 2 1 0 2 0 0 0 0

3urn 1 0 0 0 0 0 0 1

Concussion 0 1 0 0 1 0 0 0

lye Injury 7 30 2 9 1 0 9 1
'sychological 0 0 1 2 0 1 3 0
Stress
Other 15 21 11 13 10 2 32 6

Jnknown 0 0 0 1 0 0 2 1

Filename is "Combined report for 9-17-01"


W:Apps/Pdox40/worldtrade/reports/Intema!
Prepared on September 18, 2001

3. Syndromic
After five days of surveillance, there were 6637 emergency department (ED) visits reviewed. Completeness of ED
record capture increased dramatically since EIS officers were placed in the hospitals on 9/15/01 (see Table 3A).
Most ED (68%) visits were not for complaints under surveillance (category = " none of the following", see Table
3B). The combined frequency of syndromes under surveillance specifically for biologic agent release was 6.2%
(includes respiratory illness with fever, diarrhea/gastroenteritis, sepsis, meningitis/encephalitis, botulism-like
syndrome and unexplained death with fever). Case investigations are conducted daily for ED visits with the
following syndromes: sepsis, meningitis/encephalitis, botulism-like syndrome botulism-like syndrome and
unexplained death with fever. Upon further review of these cases, no evidence suggestive of a biologic agent release
has been detected. Cluster and trend analysis of syndrome data is pending.

Table 3A-Data/Census=Completeness, by hospital by ER visit date

HospCode sep!3 sep!4 seplS sep!6


Bellevue 42/. =. 33/119=0.28 126/128=0.98 127/.. =.
BkynHD . /162=. 97/141=0.69 130/149=0.87 140/147=0.95
Beth is 121/123=0.98 126/145=0.87 140/147=0.95 141/146=0.97
Coney 58/164=0.35 119/157=0.76 113/165=0.68 98/171=0.57
Columbia ./152=. 32/114=0.28 74/125=0.59 93/121=0.77
Elmhurst 107/270=0.40 218/248=0.88 212/308=0.69 192/257=0.75
Kings ./234=. 85/222=0.38 164/235=0.70 159/ 0=.
Lincoln 72/350=0.21 153/346=0.44 258/348=0.74 269/314=0.86
Long is J 90/182=0.49 124/147=0.84 165/184=0.9 175/177=0.99
Lutheran 49/137=0.36 103/126=0.82 107/131=0.82 119/128=0.93
Monte ./308=. 5/229=0.02 197/303=0.65 229/285=0.8
Mt Sinai 66/109=0.61 92/108=0.85 99/106=0.93 111/122=0.91
QueensHC 29/119=0.24 10/ 83=0.12 72/ 94=0.77 51/ 85=0.60
Staten Is U 79/154=0.51 100/141=0 . 71 127/133=0.95 126/133=0.95
St vin Mann 71/156=0.46 57/125=0.46 125/126=0.99 113/128=0.88

Table 3B- Cumulative frequency of reported syndromes

Frequency %
None listed 4480 67.5
Trauma 808 12.2
Smoke/dust inhalation 127 1.9
Exacerbation of resp illness 317 4.8
Resp Illness with fever 134 2.0
Diarrhea/gastroenteritis 236 3.6
Sepsis 18 .3
Rash & fever 15 .2
Mening/enceph 7 .1
Anxiety 80 1.2
Blank 368 5.5
Total 6590 99.3
Missing 47 .7
Total 6637 100.0
*Syndromes with no reports: Botulism-like, unexplained death with fever

File name is "Combined report for 9-17-01"


W:Apps/Pdox40/worldtrade/reports/Intemal
Prepared on September 18, 2001

Table 3C- Distribution of reported syndromes, excluding category, "None of the above"

Frequency Percent
Trauma 808 38.3
Smoke/dust inhalation 127 6.0
Exacerbation of resp illness 317 15.0
Resp Illness with fever 134 6.4
Diarrhea/gastroenteritis 236 11.2
Sepsis 18 .9
Rash & fever 15 .7
Mening/enceph 7 .3
Anxiety 80 3.8
Blank 368 17.4
Total - 2110 100.0

Table 3D-Age group distribution of ED visits (Cumulative to date)

Frequency Percent
1-1 7 years 1551 23.4
18-44 years 2911 43.9
45-64 years 1335 20.1
65 and older 786 11.8
Total 6583 99.2
Missing 54 .8
Total 6637 100.0

Table SE-Median and mean age by syndrome (cumulative)

AGE
Std. Error
SYNDROME N Median Mean of Mean
None on list 4477 36.00 36.58 .34
Trauma 807 31.00 32.59 .76
Smoke/dust inhalation 127 36.00 37.92 1.19
Exacerbation of resp illness 316 29.00 30.78 1.28
Resp Illness with fever 134 6.00 16.76 1.82
Diarrhea/gastroenteritis 236 26.00 29.32 1.66
Sepsis 18 39.00 38.89 8.24
Rash & fever 15 1.00 9.67 4.58
Mening/enceph 7 24.00 28.14 6.82
Anxiety 80 35.50 38.29 2.44
Blank 366 34.00 34.76 1.18
Total 6583 34.00 35.03 .28

File name is "Combined report for 9-17-01"


W:Apps/Pdox40/worldtrade/reports/Intemal
Prepared on September 18, 2001

Table 3F-Sydrome frequency by hospital

Frequency Percent
Bellevue 388 5.8
Brooklyn Hospital-Downtown 384 5.8
Beth Israel-Petrie 564 8.5
Coney Island Hospital 389 5.9
Columbia-New York Presbyterian 202 3.0
Elmhurst 752 11.3
Kings County Hospital 420 6.3
Lincoln Hospital 755 11.4
Long Island Jewish 568 8.6
Lutheran Hospital 385 5.8
Montefiore Medical Center 436 6.6
Mt. Sinai Hospital 370 5.6
Queens Hospital Center 174 2.6
Staten Island University-North 457 6.9
St. Vincent's 393 5.9
Total 6637 100.0

Table 3G-Syndrome frequency by date

Count
DATE
13-SEP-2001 14-SEP-2001 15-SEP-2001 16-SEP-2001 17-SEP-2001 Total
None on list 437 908 1485 1479 156 4479
Trauma 80 133 295 275 14 808
Smoke/dust inhalation 45 31 26 18 3 127
Exacerbation of resp
20 59 97 126 12 317
illness
Resp Illness with fever 17 22 38 54 3 134
Diarrhea/gastroenteritis
17 41 78 90 9 236

Sepsis 1 12 5 18
Rash & fever 3 1 3 8 15
Mening/enceph 1 6 7
Anxiety 2 4 28 41 5 80
Blank 157 147 32 26 '4 367
Total 779 1347 2094 2128 206 6588
NOTE: Full implementation of surveillance system began on the evening of 9/14/01

File name is "Combined report for 9-17-01"


W:Apps/Pdox40/worldtrade/reports/Internal
Prepared on September 18, 2001

Figure 1-Occurrence of syndromes by date


700

600

lGastroenteritis

Resp Illness w/fever

Exacerbation of resp

Smoke/dust

rauma

DATE

File name is "Combined report for 9-17-01"


W:Apps/Pdox40/worldtrade/reports/Intemal
10
Prepared on Septei.^er 18, 2001
4. Hospital Needs Assessment Survey for September 17, 2001 (GNYHA, NYCDOH, NYSDOH)
#of #ofER
Admissions Visits # of Mortalities
Date Related to Related to Related to the # of Admissions # of ER Visits (Any # of Unidentified # of Unidentified
Hospital Prepared WTC WTC WTC (Any Total) Total) Patients Patients Who Expired
Bellevue Hospital Center 9/17/01 63 300 1 300 709 -

Benedictine Hospital 9/17/01 - 1 69 364 -

Bronx-Lebanon Hospital 9/17/01 - 27 213 1,389 -

Brookdale University Hospital & Medical Center 9/17/01 1 96 368 -

Brooklyn Hospital Center 9/17/01 9 190 314 1,021 -

Cabrini Medical Center 9/17/01 9 191 140 435 -

Coney Island Hospital 9/17/01 1 41 296 '993 -

Elmhurst Medical Center 9/17/01 2 66 407 1,635 -


_
Englewood Hospital 9/17/01 - 14 - 14
Flushing Hospital Medical Center 9/17/01 0 12 0 136 465 -
_
Hospital for Joint Diseases 9/17/01 23 53 88 87
Hospital for Special Surgery 9/17/01 5 - 74 - -

Huntington Hospital 9/17/01 - 18 - - -

Jacob! Medical Center 9/16/01 1 159 - 1,378 -

Jamaica Hospital Medical Center 9/17/01 1 69 404 1,511 -

John T. Mather Memorial Hospital 9/17/01 1 11 175 667 -

Kings County Medical Center 9/17/01 4 43 436 1,935 -

Kingsbrook Jewish Medical Center 9/17/01 - 17 96 360 -

Lenox Hill Hospital 9/16/01 5 59 191 573 -

Long Beach Medical Center 9/17/01 - 11 81 277 -

Long Island College Hospital 9/17/01 41 234 1 395 1,003 -

Lutheran Medical Center 9/17/01 6 74 326 978 -

Memorial Sloan Kettering Cancer Center 9/17/01 5 5 m

File name is "Combined report for 9-17-01"


W:Apps/Pdox40/worldtrade/reports/Intemal 11
Prepared on Septeii. -r 18, 2001
#of #ofER
Admissions Visits # of Mortalities
Date Related to Related to Related to the # of Admissions # of ER Visits (Any rUnidentified # of Unidentified
Hospital Prepared WTC WTC WTC (Any Total) Total) Patients Patients Who Expired

Mercy Medical Center 9/17/01 1 16 251 530


Mount Sinai 9/17/01 - 36 665 968

Mount Sinai Hospital of Queens 9/17/01 2 50 152 666

New York Community Hospital 9/17/01 - 33 92 314

New York Eye & Ear Infirmary 9/17/01 1 74 13 254

New York Hospital Queens 9/17/01 2 59 445 -


New York Presbyterian Hospital 9/17/01 8 46 2 217 831
New York Westehester Square Hospital Medical
Center 9/17/01 1 20 90 375

New York-Cornell Weill Hospital 9/17/01 30 125 4 440 •615

North Central Bronx 9/16/01 1 12 93 694

North Shore University Hospital at Forest Hills 9/17/01 - 31 133 462


North Shore University Hospital at Plainview 9/17/01 - - 110 479

NYU Hospital Center 9/17/01 2 135 - 360


Parkway Hospital 9/17/01 - 31 : 89 260

Peninsula Hospital Center 9/17/01 - 35 83 421


Queens Hospital Center 9/16/01 - 16 189 800
Roosevelt Hospital 9/17/01 4 117 261 656
St. Luke's Hospital 9/17/01 - 48 319 847
St. Vincent's Hospital Manhattan 9/17/01 105 558 4 320 1,060

SUNY Downstate Medical Center 9/17/01 1 48 96 612

Victory Memorial 9/17/01 2 64 180 482


Woodhull Medical and Mental Health Center 9/17/01 2 99 288 1,598

TOTAL 339 3,344 12 9,035 26,616

File name is "Combined report for 9-17-01"


W:Apps/Pdox40/worldtrade/reports/Internal 12